Individual health plans are those insurance plans that a person buys on their own. Most health insurance plans are through employers. For those who own their own business or aren’t offered health insurance through their place of employment, individual health plans are necessary.
Before committing to a policy, it’s important to research all of your options and possible rates. Knowing what your monthly rates will be and if there are copayments or deductibles is important.
To search for individual health insurance quotes, type in your zip code. This will help you compare different health insurance quotes.
According to the Department of Managed Healthcare for California, finding individual healthcare can be challenging especially for those with health conditions. However, there are insurance companies such as COBRA that will cover you even if you have health conditions whereas other insurance companies might not.
What are individual rights when it comes to individual health plans?
There are health plans that will deny or accept you based on your health history. This is completely legal. However, it’s illegal for an individual health plan to deny you coverage because of:
- National origin
- Sexual orientation
- Marital status
In addition, health plans cannot deny you coverage because of a family history of genetic diseases (only if you’re diagnosed with the disease at the time of applying) or a family history of breast cancer. You also can’t be denied if you have a mental or physical disability.
What are the reasons for getting a refusal on an individual health insurance plan?
Getting a denial or refusal on an application varies from each plan. There are several reasons for refusals. If you have health problems that you have not seen a doctor about, they might refuse you.
Those health problems that cannot be explained by a doctor are red flags for some insurance companies. If you’re undergoing treatment for a condition and have not finished, that could be considered grounds for refusal.
There are also specific health problems that are marked as automatic denials for some health insurance companies, which include some of the following:
- Cancer (which is under treatment)
- Complications with the diabetes
- Certain heart diseases
- Transplant history
- Severe mental health disorders such as bipolar or schizophrenia
Some others that are red flags to insurance companies are:
- Multiple sclerosis
- Sleep apnea
- Kidney failure
Why did I only get offered high premium rates for individual health plans?
For those who don’t have severe health problems, but have some health issues, individual health plans could be offered with either high premium rates or limited benefits. This could be for those people who have recovered from health problems or for those who have some minor ailments as well.
Health insurance companies are in the business of making money. If there’s a risk that your ailments could cost them more than what they’ll take in, they’ll have to compensate for that by giving you either less benefits or higher rates.
Each plan and application is treated separately. However, the following conditions could potentially cost you more in premiums or less in terms of benefits:
- Lyme’s disease
- Mild mental health diseases (mild depression for example)
- Ear infections
- History of having a stroke
Applications for individual health insurance will also take into account your weight in relation to your height. If you’re overweight or obese, you could very well be denied insurance or offered it with limited benefits and higher premiums.
What applications tend to do is look at your body mass index (BMI) and see if it’s in a normal range. According to the National Heart Lung and Blood Institute, the BMI categories are the following: BMI calculation 18.5 and less is under what weight you need to be, normal is a BMI of the last number up to 24.9, overweight is twenty-five to 29.9 and obese is a BMI of thirty or more.
In most cases if your BMI is higher than 39, you could be refused coverage. If it’s between 30 and 39 you might be offered insurance, but at a higher premium or with less benefits.
In order to find an individual health plan you first need to research that companies you would most likely need or want.
You can research online different health insurance rates right here. Simply enter your zip code in the free box and start comparing quotes!